I want to thank everyone for their comments...about 30 seconds after posting yesterday I did a full-on forehead slap and went, "Jesus God, girl, what have you DONE? The assvice, it will destroy you!"

But instead of dozens of I've-missed-the-point-entirely-and-want-to-lecture-you-about-mercury-levels-in-tuna-fish comments, I got dozens of thoughtful, supportive and unbelievably articulate comments. Would y'all talk to my doctor for me? Because you are like, SMART and shit.

(One note of anal-retentive clarification: I am not getting an ultrasound at a mall. No one ever said anything about a mall. I'm talking about a 4D "limited medical ultrasound" that uses the same equipment a doctor uses for a Level II scan at a very nice, reputable facility that in no way compares to some 25-cent blood pressure assessment at the mall right next to the Orange Julius.)

But your comments have inspired me not to do that right now. We're sticking with our original plan: extra-bonus 4D scan at around 30 weeks for our own entertainment, full medical ultrasound by 22 weeks.

My doctor just doesn't know that second part yet.

I really think my baby is just fine. While this whole situation has raised my (already admittedly high) anxiety level to an intrusive point, the anxiety stems from my somewhat-wretched ability to stand the fuck up for myself and a tendency to shy away from confrontation.

However, I'm also het up on the principle of the whole thing. And that principle is called: This is what I want, and you're not giving me a single valid reason why I shouldn't get exactly what I want, and in fact, you're not making any sense at all.

An additional EIGHT WEEKS seems like an awfully long time to postpone a diagnostic ultrasound simply because you're concerned about "picture quality."

This brings up the nagging fear that Rachel hit the nail on the head with her comment: "it sounds to me like having all of his patients wait until 26 weeks is an awfully convenient way of making sure everyone carries to term, regardless of what may be right for the mother/child."

Ohhhh. BAD DOCTOR. Do not even GET ME STARTED.

Look, Jason and I want this baby. This baby is the most wanted baby in the history of want. I love this baby with every fiber of my being and I loved it from the instant I saw those two pink lines. (Well, probably from the instant I saw those two pink lines on say, test stick number four, only because I thought the first three were fucking with me.)

So you give me some bullshit reason about delaying a routine procedure because you're afraid I might make some flip decision about my child's life if you let me have it sooner?

Dude, that gets me so mad I can't fucking SEE STRAIGHT. And it makes me say the word "dude."

Now, I could be seeing a sinister hidden agenda where there is none. I just won't know until I speak with him directly, most likely on Monday, and I can get a better grasp on his whole (whacked-out) (stupid-ass) approach to ultrasounds. We'll see how that goes. And then we'll either put this whole business behind us, or my next request for comments will be for the names of obstetricians in the Washington, DC area.

Either way, I'm getting the damn ultrasound referral from him. Oh, but yes.

Okay, scary picture and all, but I think you're going to see a scarier one of me if you don't get some damn Aruba pics posted soon! :)

Good luck w/getting the whole doc thing sorted out...seems to me like Rachel was right with her assessment... There doesn't seem to be any other valid reason for his refusal. I'd be looking into other doctors (who don't let their political agendas get in the way of treatment), if it were me, but it all depends on what you're comfortable with.

Ok the Rachel comment does make a lot of sense and I would be livid if that is his reason. I hate when someones personal beliefs come into play in profesional situations. Especially if its my health on the line.

You are better than me I would have probably already found a new Dr and called the medical board. But I'm a bitch.

Your mean face reminds me of the ONLY time my hubby has ever been scared for his life in regards to me. I was pregnant, reached for the Spamoni ice cream in the fridge, took off the lid and the carton was EMPTY! I said, "DID YOU EAT ALL OF THE ICE CREAM AND PUT IT BACK IN THE FRIDGE!" And he paused for a moment and said, "Uhhh. Yes?" There was legitimate fear in his eyes. I thought for a minute he was going to flee the country.

And that doctor should know. You just DON'T FUCK with a PREGNANT WOMAN! And that is most disturbing that a doctor would sneakily push his political/religious adgenda on his patients. If men were the ones getting pregnant the world population would have died out by now. So I guess there wouldn't even be any options or oppositions. But as a person who is NOT YOU, he has no right to do so. And even less as a male!

Bad picture quality could mean having to to another ultrasound at the 26 week point, besides the "early one" at 20 - 22 weeks. HMO's don't like paying for extra procedures. Bottom line is the HMO's bottom line. Period. Doc's only doing what the HMO requests - so he can stay a member and get cool patients.

And my insurance already paid for ultrasounds at 7 weeks and 11 weeks just fine and dandy, and will indeed cover as many as my doctor deems necessary -- as long as I get them at a third-party imaging center. In the doctor's office, they'll cover them, but I pay for them up front and then get reimbursed later. Either way, doc gets his money.

So I wish I could chalk this up to a simple "dang those pesky insurance companies" thing, but I can't.

Yeah, this whole thing sounds pretty hinky to me. I was willing to go for Brian's explanation, or for some kind of cost-effectiveness vs. sensitivity thing, but I'm guessing your doc is thinking along the lines that Rachel suspects - maybe not to impose his own feelings about termination onto you, but because he figures you won't terminate anyway? Either way, though, that's not very patient-centered of him. And we're aaaallll about being an Advocate for the patient, not patronizing the patient, in modern medicine.

At the very, very least he should be willing to come up with a reason NOT to do the scan other than "You'll see the sex more clearly at 26 weeks, little lady."

(I feel the urge to beep that girl's nose, not to cringe from her in terror, I'm sorry to say. Maybe your mad photographs too cute and you're really scary in person.)

I really don't understand his refusal, especially now that you've explained your insurance situation. My doc doesn't strictly do 10 week u/s but he sent me for one after I flipped when we didn't hear the heartbeat (which it was pretty early). Anyway, the point of this boring totally self-centered antedote is that the doctor should not be above prescribing a procedure for your peace of mind. Calm, happy, centered Amalah = Calm, happy, healthy Babalah, right?

I honestly hope that your doctor isn't pushing his political viewpoint on you, as I hate doctor's who emphasize the fact that we're woman and, so by nature, we must be prone to hysteria. WTF. Not baby-related, but I had a doctor told me that I was overreacting and being hysterical about the fact that I woke up one morning, unable to move my neck and my left arm was numb all the way down to my fingertips. Stupid, insensitve docs.

What Rachel said is exactly what I thought as soon as I read about your conversation with him. It sounded eerily like this doctor was making the decision for you, without even asking.

Good luck on Monday! I always complain to my mother that I can't stand up for myself and she always says "oooooh wait until you have kids, then you would beat the living shit out of anyone who gets in your way or hurts your baby, then you will most certainly have no problem standing up for yourself."

Go Amalah! Stand up for Babalah, who wants to be seen! I think she is a girl, in case we are going to start placing bets. Just because. I have a feeling : )

I agree with Princess. Sometimes you have to be a "bitch" to get what you want.

It is only when we stand up and say, 'No, I'm the paying customer, this is what I want...' that we get the results we seek.

And if someone like Rachel hypothesized that the doctor's reasons for doing so could be "this" I'd be on that phone first thing...(when he got back in the office that is) so I hope you do call him and ask him, point blank, exactly WHY, in FULL detail, he waits. Half assed answers are not acceptable.

ACK! I would KILL my doctor. As a matter of fact, I just fired my doctor. Oh, I was able to get the 20 week ultrasound as I am considered "high risk" just because I am just over 35, but I could not take the 2+hour late doctors appts that I took a long lunch for and the non-existant office hours before or after regular working hours. Basically, I went for a lunch appt and I only saw the medical assistant because HE WENT FOR A WALK IN CENTRAL PARK TO SNIFF THE PRETTY FLOWERS ON A NICE DAY. Even the head of the dept said "ah, that is just like him, such a hippie. We lose him on nice days." WHAT THE HELL?? So Amy, YOU are in control. YOU can voice your concern or change docs if you like. I wouldn't wait much past 22 weeks to do it, but the ball is definitely in your court. Picture quality is BS. The inital gross anatomy ultrasound makes sure all the parts are where they are supposed to be and if ANYTHING is shown to be wrong, they still have time to do the amnio if needed. Waiting til 26 weeks is BS, but the ball is in your court.

And seeking a different doctor if this one isn't working with you doesn't sound crazy either. This guy is not a cruise director whose job it is to give you a great trip. His job is to give you a *healthy baby.*

GRRRRR! Don't make her angry, you wouldn't like her when she's angry. I say if he doesn't obey your command sick Ceiba on him. Any Dr. who isn't familiar or sensitive to the anxiety of pregnant women doesn't deserve to have ankles.

Seriously. Your doc needs to get the smack down laid on him, hardcore. I'm all pissed off for having to wait until this coming Wednesday (22 weeks) for my gender ultrasound because I could have had it weeks ago but noooooo, I have to live in Pennsylvania where you can only get a baby Dr's apt scheduled right away if your baby's head is hanging out of your crotch.

Someone may have suggested this, but do you have a tech school around your area? I knew a friend of a friend who knew someone in school for such things that require an ultrasound. They gave a second ultra sound (first one the baby would not uncross its legs!) for free with a tape on a very fancy up-to date machine because they needed to log hours anyway. I am not sure why we had to sneak in at the dead of night and wear disguises...

Good luck. I went through some annoyance with my u/s as well but I threw a fit and it worked out. I'm 27 weeks now. At my first appt. around 11 weeks, they told me to go ahead and schedule my 20 week u/s and the first day I could do that was March 10th which was exactly 20 weeks. So I of course scheduled it at March 10th at 8 AM. We ended up finding out the sex at 18 weeks because I had been put on bedrest for cramps and they were doing an in-office trans-vag u/s to check the length of my cervix or some crap and my doctor, who kicks ass, was like "Do you know the sex of the baby?" and I said no, we're going in two weeks for the u/s. Well then she said she could tell us right then which I guess technically they're not supposed to do at that point for some reason, but again, she's awesome, so she did. And let me tell you, that kid was ass up against the camera and letting his balls hang out for the world to see. So the thing about not being able to tell the sex as well at 20 weeks is just crap. Then my next appt. was at 4:30 the day before my scheduled 20 week u/s and when I go in the nurse starts telling me how even though I have it scheduled for the next day at 8 am, their policy has changed since I was first seen and they are telling all the new preggies not to schedule it until 23-24 weeks because they can usually see the heart and some of the organs better at that point. She kept insisting that I would have to reschedule and I was adamant. My husband had already taken the day off work and even though we knew the sex already I really wanted to see the baby again and know that he was alright and measuring how he was supposed too, etc. Her big point was if they couldn't see the baby well enough I would have to go back and I was like "Ok, not really a problem cause my insurance pays for it so I'm going to the appt. that I made 3 months ago and if I have to go back it's fine." Then my kick ass doctor finally intervened and told her to shut up and just let me go. So, we got the u/s at 20 weeks but we did actually have to go back at 22 weeks because the kid was stubborn as hell and wouldn't turn over to let the tech. see his heart. Which has nothing to do with his age, just that he was being difficult. I'm sure this long involved story doesn't really help you at all, but generally if you're bitchy enough about something they will cave in. And if you're doctor is that stubborn about it, it sounds like something is up. Remember that this is the person who will help bring your child into the world and if he won't listen to you on this then maybe you don't want him responsible for something that huge. Oh and also, I'm totally jealous that you have that nice u/s place by you. Having not seen my baby in over a month, I'm dying for new pics.

Look, this is none of my business, and I know that, but oh, this is the internet! Nothing I say matters, right? (cough)

Anyway, I work in the insurance department in a Doctor's office. I am by no means an expert, but I know a few things. It may not matter that you have a PPO and not an HMO, if your Doc is in the PPO network. Some insurance companies put pressure on the doctor by keeping very close track on every referral an in-network doctor writes. If he/she write "too many", they may try to kick them out of the network, or start denying payments, etc., which is a pain, to say the least. The reason is because every referral costs the insurance company more money. And I'm sorry to say they don't work for you, they work for themselves.

(1) The ultrasound isn't very reliable until about 20 weeks into the pregnancy to determine the sex of your child; physical (not genetic) sexual differentiation in the fetus doesn't occur until after the 13th week, and can't really be discerned until after the 18th week. That's a medical fact, and 18 weeks is way past the first trimeseter, so your doctor is prolly not forcing you into his sinister plot to enslave women into motherhood. In spite of Sioban's son mooning the device her doctor used, you could have looked that up on the internet.

(2) Even at 26 weeks, the ultrasound is not fool-proof. So unless you actually get a profile of your baby's genitals in the 4D whatsis you plan to use, it's still only a good guess.

(3) The only fool-proof (as if) method of determing the baby's sex prior to birth is the amniotic fluid test in which they stick a large needle into you and take out fluid to do genetic testing. THAT sounds like fun, yes?

Shopping is important, but being mad at your doctor because you want to shop is not very sound patient behavior. Shop for baby furniture if you can't wait, then you can pick colors in a couple of weeks.

Cute Frank. I really, really like it when you compare having an amniocentesis with being a bad parent. Very, very sharp. Because, of course, the only reason to get an ultrasound is to check gender and shop. Not to look for actual problems, etc.

"THAT sounds like fun" was not intended to say "Amalah is a (or will be) bad parent". It was a reference to my personal phobia toward big needles. However, rather than deconstructing my previous post here, and rather than try to make me look better, I should just eat crow.

I said what I said, and it read like it read, and if it came across as "I think Amalah (may she live forever) is (or will be) a bad parent", then I am actually a dolt. I apologize.